parts of government insurance in us healthcare

Classification of the American Health Insurance Industry
Classification of the American Health Insurance Industry
Means how many health insurance companies are there in US
and how many parts are there
and for whom they are eligible
So friends, welcome back to my wolrdinfotoday.com
Friends, we are talking about medical billing process
and today’s topic is about health insurance companies
that how many health insurance companies are there in US
and how many parts are there and how they work
Friends, this is an important chapter
if you want you can make notes
because any interviewer can ask you
that tell us about commercial plan or manage care plan
or government plan
so these are all important questions
if you want you can make notes
so let’s start this video
BENEFITS OF IMPORTANCE OF HEALTH INSURANCE COMPANIES
All insurance companies have different ways
their eligibility is different, process is different
so let’s come to know about it
This picture on the screen now is insurance company
part in US Health Care
just keep this picture in your mind
because there is lot of confusion
so just keep this picture in your mind and understand
these are three types of insurance
now let’s talk about it in detail
in today’s video, I will talk about
public insurance i.e. government insurance plan
I will talk about private insurance companies in next video
1st is Medicare
2nd is for people aged 65 to 65
and disabled people below 65 years of age
and people of any age suffering from ESRD
so Medicare is a federal government program
and it is for people who are above 65 years of age
or for disabled people
even if they are below 65 years of age
but they are eligible in Medicare
3rd possibility is when
even if they are suffering from ESRD
they are eligible in Medicare
ESRD means End Stage Renal Diseases
ESRD diseases are related to kidney
so if there is a kidney related patient
they are eligible in Medicare
now let’s talk about Medicaid
Medicaid is for those people
whose income falls under
National Priority Guidelines
and it is jointly run under Federal and State Government
so this Medicaid program is run by
Federal and State Government
so basically Medicare is based on age, disability
or any specific ESRD
and Medicaid is based on income
so there is a difference between Medicare and Medicaid
if someone asks you about the difference
you can tell them
key to remember in case of Medicaid
when you work in the process of medical billing
and you get Medicaid insurance
it is always been the last pair
we cannot bill to the Medicaid patient
Medicaid is always the last pair
if you have primary and secondary insurance
and if there is Medicaid
then Medicaid will be secondary
Medicaid is always the last pair
and we cannot bill to the patient
let’s say no services are covered under Medicaid
or Medicaid denies some services
then we cannot bill to the patient
it depends on the patient’s consent form
in some cases we can bill to the patient
and in some cases we cannot
so you have to know this in detail
let’s talk about TRICARE
Department of Defense Health Care Program
formally called CHAMPUS
it covers Army, Navy, Air Forces
Marines and Coast Guard
so basically TRICARE is for Department of Defense
let’s talk about CHAMPVA
CHAMPVA is the program to provide health care benefits
for dependents of Veterans
Veterans are those who have served in the Army
like Navy, Air Force
but they are not working now
they may be disabled
they may be injured or disabled
so such people are called Veterans
and it covers the dependents of those Veterans
like their spouse, kids, family
CHAMPVA is provided by Department of Veterans Affairs
CHAMPVA is free
let’s talk about WORKERS’ COMPENSATION
WORKERS’ COMPENSATION is a program
mandate by state governments
that require employers to cover medical expenses and wages
loss for workers who are injured on the job
or develop a job related disorder
WORKERS’ COMPENSATION is a program
that requires employers to cover medical expenses
and wages

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